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Abstract Number: 1298

Gout and the Risk of Parkinson’s Disease in Older Adults: A Study of U.S. Medicare Data

Jasvinder A. Singh and John Cleveland, Rheumatology, University of Alabama at Birmingham, Birmingham, AL

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: gout

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Session Information

Date: Monday, October 22, 2018

Session Title: Metabolic and Crystal Arthropathies – Basic and Clinical Science Poster I

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: In the presence of limited available data, our objective was to assess the association of gout with the risk of incident Parkinson’s disease (PD) in older adults ³65 years.

Methods: We used the 5% Medicare claims data from 2006-2012 for this cohort study. Gout was identified by the presence of two claims for gout at least 4 weeks apart, with International Classification of Diseases, ninth revision, common modification (ICD-9-CM) code of 274.xx. Study outcome was incident GCA, identified by two claims for PD with an ICD-9-CM code of 446.5, at least 4 weeks apart and an absence of PD claims in the baseline 365-day period, a valid approach. We used multivariable-adjusted Cox proportional hazard models to assess the association of gout with incident GCA, adjusting for potential confounders/covariates including demographics (age, race, gender), comorbidities (Charlson-Romano comorbidity index), and medications commonly used for cardiac diseases (statins, beta-blockers, diuretics, and angiotensin converting enzyme (ACE)-inhibitors) and gout (allopurinol and febuxostat; Model 1).  

Results: In a cohort of 1.72 million people, the mean age was 75 years (standard deviation [SD], 7.6), mean Charlson-Romano comorbidity index score was 1.60 (SD, 2.39), 58% were female, 86% were White and 37% had Charlson-Romano comorbidity index score of ≥2. Of these, 22,636 people developed incident PD during the study follow-up, 1,129 with gout and 21,507 without gout, with respective crude incidence rates of incident PD of 3.7 vs. 2.2 per 1,000 person-years, respectively. Gout was associated with a higher risk of PD in the main analysis, 1.14 (95% CI, 1.07, 1.21). Sensitivity analyses confirmed main findings. No gender or race differences were noted, but the risk differed slightly by age; ages 65-75, 75-85 and >85 had hazard ratios of incident PD with gout of 1.27 (95% CI, 1.16, 1.39), 1.07 (95% CI, 0.97, 1.16) and 0.97 (95% CI, 0.79, 1.20), respectively (Table 1). 

Conclusion: Gout was associated with a higher risk of incident PD in older adults. The risk of PD with gout was highest in the age group 65-75 years. Mechanisms of this increased risk need to be evaluated in future studies. 

 

Table 1. Association of gout with Parkinson’s Disease, in pre-defined subgroup analyses, varying by age, gender and race

 

Multivariable-adjusted (Model 1)

Multivariable-adjusted

(Model 1)

Multivariable-adjusted

(Model 1)

 

HR (95% CI)

P-value

HR (95% CI)

P-value

HR (95% CI)

P-value

 

65-<75 years

75- <85 years

≥85 years

Gout

1.27 (1.16, 1.39)

<0.0001

1.07 (0.97, 1.16)

0.17

0.97 (0.79, 1.20)

0.77

 

Female

Male

 

 

Gout

1.17 (1.06, 1.30)

0.003

1.11 (1.03, 1.20)

0.006

 

Black

White

Other race

Gout

1.09 (0.87, 1.36)

0.46

1.13 (1.06, 1.21)

0.0003

1.36 (1.05, 1.77)

0.02

Interaction terms: Gout*age p-value <0.0001; Gout*gender p-value = 0.52; Gout*race p-value = 0.65

HR, Hazard ratio; CI, confidence interval;

Bold estimates represent those with statistical significance, i.e., p-value <0.05

 


Disclosure: J. A. Singh, Takeda, Savient, 2,Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta/Horizon and Allergan pharmaceuticals, WebMD, UBM LLC, Medscape , Fidia pharmaceuticals and the American College of Rheumatology, 5; J. Cleveland, None.

To cite this abstract in AMA style:

Singh JA, Cleveland J. Gout and the Risk of Parkinson’s Disease in Older Adults: A Study of U.S. Medicare Data [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/gout-and-the-risk-of-parkinsons-disease-in-older-adults-a-study-of-u-s-medicare-data/. Accessed January 27, 2023.
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